What happens if you have lipo and skin removal and the upper arm becomes smaller than your forearm?

Hello, and thank you for your question regarding what happens if you have lipo and skin removal, and the upper arm becomes smaller than your forearm. Thank you for your hypothetical question. First, you should consult with an experienced board-certified plastic surgeon. They should be well-qualified to perform arm reduction surgery. Second, during your consultation, your chosen plastic surgeon should be able to show you in the mirror the effect of the brachioplasty and your expected results. Third, during your consultation, you and your plastic surgeon should decide if you need any forearm work. If you decide to undergo forearm surgery, the forearm surgery is usually combined with the upper arm lift. Most experienced board-certified plastic surgeons who specialize in reconstructive plastic surgery after massive weight loss are skilled and perform full-length brachioplasty surgeries. During this procedure, upper arm and forearm liposuction is performed. Then, an incision is made from the outer or pinky side of the wrist to the elbow, and then extends from the elbow to the armpit. Forearm surgery is complicated due to the anatomy and the tight space. However, that does not mean that qualified plastic surgeons do not perform it. Therefore, the question of whether you need forearm surgery would be answered during your preoperative consultation. Alternatively, you could stage the arms between the upper and lower arms. Usually, this is rare and unnecessary. However, if you want to see what the upper arms look like before embarking upon forearm surgery, that is a reasonable request. Good luck. When conducting research, be sure that your chosen plastic surgeon is experienced in performing forearm surgery. Be warned--forearm surgery is technically not easy. Since a brachioplasty and forearm surgery are difficult procedures, please seek an experienced, board-certified plastic surgeon with significant experience performing these types of arm lifts. Do your research. Make sure your chosen plastic surgeon has performed at least 150 arm lifts. Make sure they have the before and after pictures to prove it. Please carefully look over their before and after pictures and check their reviews on RealSelf. Good luck. Sincerely, Dr. Katzen, MD, MBA. (Plastic Surgeon, President of the American Society of Bariatric Surgeons, certified by the American Board of Plastic surgery, Fellow of the International Society of Aesthetic Plastic surgery, American College of surgery, International College of Surgery, and American Board of Metabolic and Bariatric Surgery, and member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery, RealSelf Hall of Fame, and RealSelf Doctor Advisory Board for Medical Review and Consumer Panel.)

Ideally your plastic surgeon would recognize the need before the surgery to reduce the forearm as well. You should find a surgeon who does a ton of upper extremity contouring and is comfortable knowing beforehand if you'll also need forearm reduction to make sure you dont end up with Popeye arms. We reduce the forearms all the time. It's hard to hide the scar and many surgeons are uncomfortable with the forearm anatomy, but removing skin is fine to do and some people need the forearm liposuctioned and skin removed.

Thank you for your inquiry! We would love to meet and discuss your concerns! The whole arm should be taken into account when the surgeon is forming a surgical plan. Schedule a consultation with a Board-Certified Plastic Surgeon to help you reach your goals.

In the situation you're describing (assuming there is adequate fat to remove) liposuction can be performed to achieve better balance/proportion between the forearm and upper arm. Typically a surgeon will take into account the size of your forearm and try to match the upper arm to that when performing the brachioplasty.

Although this can be a possibility, it is unlikely. The reason is the muscles in the upper arm like biceps and triceps are much larger than all of the numerous muscles and structures in the forearm. The lipo and arm lift is a contouring procedure that removes skin and fat only to restore normal, anatomic shape of the upper arms. Of course, proportions matter, and there is an element of artistry & craftsmanship that goes into planning the surgery to ensure that your arms won't look weird after the surgery.

Thank you for your query. The situation you are referring to is extremely unlikely. However, if it happens, the situation will need to be handled based on the reason for the problem. After the skin had some time to settle down, some muscle building exercises can be recommended, and if excessive fat has been removed, some fat grafting may help. Liposuction of the fore-arm will be an unlikely option especially if the skin is a little loose. Please find an experienced board certified Plastic surgeon who can examine you and help you with all your concerns. All the best!

This is an interesting question as it could happen. How would you keep your risk low? By selecting an experienced board certified plastic surgeon for your procedure. During a consultation your surgeon would examine you and discuss your goals for surgery. Open communication is key in helping you to achieve the desired result.

This is a very smart and important question to ask, especially if you’re considering or planning arm liposuction and brachioplasty. Here’s a detailed, honest look at what could happen and how it’s usually addressed:
Hypothetically, if the upper arm becomes smaller than the forearm after lipo and brachioplasty:
Yes, it could happen—especially in individuals with significant volume loss in the upper arms (due to fat removal and skin excision) and relatively thicker or muscular forearms. The result could be a disproportion where the upper arm appears slimmer than the forearm, which can look visually unbalanced or even unnatural.
Would a plastic surgeon notice this possibility ahead of time?
A good, experienced plastic surgeon absolutely should recognize this as a potential outcome during your consultation and surgical planning. Surgeons routinely assess body proportions—especially for procedures like brachioplasty, which affect contour and symmetry.
That said:
• Every surgeon has different approaches to how aggressively they reduce tissue.
• If you don’t bring up your concern, they may not prioritize forearm/upper arm proportion unless it's visibly obvious pre-op.
• Some surgeons may prioritize getting rid of the excess skin and fat without fully considering how your forearms might appear afterward—so voicing this specific concern is a smart move on your part.
If it happens post-op, would you need another procedure?
Potentially, yes, but only if the imbalance bothers you:
• Forearm liposuction is technically possible but more delicate. There are more tendons, veins, and nerves closer to the surface, so surgeons are more conservative.
• Forearm lifts (skin excision) are very rare due to significant scarring and lower patient satisfaction—they’re typically only done in cases of massive weight loss.
• If your forearms are muscular or solid rather than fatty, there may not be much you can do aside from building up your upper arms slightly (e.g., via fitness or fat grafting).
What can be done for the forearms?
If treatment is needed:
1. Mild liposuction may be an option for fat reduction, if your skin is elastic enough to retract on its own.
2. Laser-assisted lipo (e.g., Smart Lipo) or radiofrequency-assisted lipo (e.g., Body Tite) can help tighten the skin.
3. Surgical lift – Rarely done, but possible in extreme cases with a trade-off of visible scarring from wrist to elbow.
You should definitely consult a board-certified plastic surgeon who specializes in post-weight loss or body contouring procedures.